Breakthrough pain: progress in management

Abstract

To present recent developments in the treatment of breakthrough pain (BTP) in cancer, we reviewed the literature with a special focus on last publications using Medline. BTP is distinguished from other pain syndromes because of its unique physiopathology, clinical and socio-economic importance and treatment considerations. Despite medical awareness, BTP remains underdiagnosed and therefore undertreated. Clinical information is essentially based on case series and expert opinion. Fentanyl, oral or nasal, remains the molecule of choice to treat BTP, but very important development is ongoing to improve tolerance, efficacy and pharmacokinetics. Data from epidemiological and clinical studies show that breakthrough pain remains a challenge especially among cancer patients. An accurate diagnosis followed by a specific treatment is the key for an effective pain relief.